Collaborative eye tracking: a potential training tool in laparoscopic surgery

Surg Endosc. 2012 Jul;26(7):2003-9. doi: 10.1007/s00464-011-2143-x. Epub 2012 Jan 19.


Background: Eye-tracking technology has been shown to improve trainee performance in the aircraft industry, radiology, and surgery. The ability to track the point-of-regard of a supervisor and reflect this onto a subjects' laparoscopic screen to aid instruction of a simulated task is attractive, in particular when considering the multilingual make up of modern surgical teams and the development of collaborative surgical techniques. We tried to develop a bespoke interface to project a supervisors' point-of-regard onto a subjects' laparoscopic screen and to investigate whether using the supervisor's eye-gaze could be used as a tool to aid the identification of a target during a surgical-simulated task.

Methods: We developed software to project a supervisors' point-of-regard onto a subjects' screen whilst undertaking surgically related laparoscopic tasks. Twenty-eight subjects with varying levels of operative experience and proficiency in English undertook a series of surgically minded laparoscopic tasks. Subjects were instructed with verbal queues (V), a cursor reflecting supervisor's eye-gaze (E), or both (VE). Performance metrics included time to complete tasks, eye-gaze latency, and number of errors.

Results: Completion times and number of errors were significantly reduced when eye-gaze instruction was employed (VE, E). In addition, the time taken for the subject to correctly focus on the target (latency) was significantly reduced.

Conclusions: We have successfully demonstrated the effectiveness of a novel framework to enable a supervisor eye-gaze to be projected onto a trainee's laparoscopic screen. Furthermore, we have shown that utilizing eye-tracking technology to provide visual instruction improves completion times and reduces errors in a simulated environment. Although this technology requires significant development, the potential applications are wide-ranging.

Publication types

  • Evaluation Study

MeSH terms

  • Analysis of Variance
  • Computer Simulation*
  • Education, Medical / methods*
  • Equipment Design
  • Eye Movements*
  • Female
  • Fixation, Ocular*
  • Humans
  • Laparoscopy / education*
  • Laparoscopy / instrumentation
  • Male
  • Reinforcement, Verbal
  • Software
  • Teaching Materials*